Everybody Read online

  I didn’t agree with Reich that the orgasm could bring down the patriarchy or stop fascism (as Baldwin tartly put it in an essay on Reich, ‘the people I had been raised among had orgasms all the time, and still chopped each other with razors on Saturday nights’), but his work on sex took me to Weimar Berlin, the birthplace of the modern sexual liberation movement, the numerous achievements of which seemed less secure by the day. Though Reich placed enormous faith in the liberatory possibilities of sex, sexual freedom is not such a straightforward matter as we might sometimes like to think, since it shares a border with violence and rape. Thinking about these less comfortable aspects of sex brought me to the Cuban-American artist Ana Mendieta, to the radical feminist Andrea Dworkin and to the Marquis de Sade, who between them have mapped one of the most difficult regions of bodily experience, where pleasure intersects with and is usurped by pain.

  While the theories of Reich’s later years were often bizarre, his battle with the Food and Drug Administration and subsequent imprisonment were clearly not unrelated to the issues with which he grappled throughout his life. What does freedom mean? Who is it for? What role does the state play in its preservation or curtailment? Can it be achieved by asserting the rights of the body, or, as the painter Agnes Martin believed, by denying the body altogether? Reich’s liberation machine might not have cured cancer or the common cold, but it did serve to expose a system of control and punishment that is invisible until you happen to transgress it in some way.

  His imprisonment in USP Lewisburg drew me to consider the paradoxical history of the prison reform movement, encountering the radical ideas of Malcolm X and Bayard Rustin. They in turn opened up the realm of political activism and protest, the bodily struggle for a better world. Here I came upon the painter Philip Guston, who documented the cartoonish, grotesque forms of those who try to limit freedom, as well as the singer and activist Nina Simone, who spent her life trying to articulate how it might feel to be free, the ultimate Reichian dream.

  Like all of these people, Reich wanted a better world, and furthermore he believed it was possible. He thought that the emotional and the political impacted continually on the actual human body, and he also believed that both could be reorganised and improved, that Eden could even at this late juncture be retrieved. The free body: what a beautiful idea. Despite what happened to him, and despite what was happening to the movements in which he’d participated, I could still feel that optimism vibrating through the decades: that our bodies are full of power, and furthermore that their power is not despite but because of their manifest vulnerabilities.

  2

  Unwell

  WHEN I WAS SEVENTEEN or so I had irregular periods, also acne, the former concerning enough that my mother decided I ought to see a specialist. We drove into London on a sweltering afternoon, past the dusty plane trees of the Cromwell Road. At the hospital, I was chastised for not having a full bladder and made to drink several penitential glasses of Ribena. The ultrasound technician plied her wand over my belly and then a consultant informed me I had polycystic ovaries and would need IVF to get pregnant, which as it happened wasn’t true and was probably a reckless thing to tell a teenage girl.

  The condition was enigmatic and basically untreatable, a hormonal disturbance marked by clusters of fluid-filled follicles in the ovaries. Its symptoms included acne, weight gain, hair loss and hirsutism, all related to elevated levels of testosterone. The only treatment on offer, ironically enough, was the contraceptive pill, which would at least give me the illusion of regular periods and might also help reduce my zits, though the small print warned that the opposite was also possible.

  It was the mid-1990s, and I was a punk–hippie hybrid, with an undercut and a pack of tarot cards wrapped in black silk. I didn’t want to take a pill, to eradicate symptoms without understanding their cause. I was an awkward occupant of my body at the best of times. It felt like an animal I couldn’t talk to, a dumb, not always loyal horse. It went on without me, and its failure to function on schedule accentuated my sense of mystification. Sometimes at night I lay on my bed and tried to project my astral body onto the ceiling. Sometimes too I woke to find my body was paralysed, immobile as a block of wood, a terrifying experience I discovered years later was called sleep paralysis. I’d lie there, concentrating all my energy on the formidable task of twitching my toe, to break the spell. What if I got stuck there, and nobody knew I was still inside?

  At around this time, I came across a copy of The Holistic Herbal by David Hoffmann, a hippie bible with a beguiling spiral of hand-drawn flowers on the cover. Under its benign guidance, I began experimenting with herbs, jotting down properties and contra-indications in my diary. I bought dried raspberry leaf and chasteberry from a local wholefood shop, to try and regularise my periods. They sounded like prescriptions from a fairy tale but they did possess actual, verifiable effects, at least as far as my ovaries were concerned.

  After a brief dalliance with an English degree and a year on protest camps, I decided to apply to do a degree in herbal medicine. I was exhausted and burned out by protest, and I badly wanted to do something positive with my life, to contribute to a future that didn’t despoil the environment. I wanted to formalise my understanding of the body, and I was fascinated too by the idea that it might have its own language, distant from speech but just as eloquent and meaningful, composed of symptoms and sensations rather than words. A Mickey Mouse degree, my dad liked to say, but it was four solid years of Mickey Mousing, plus a foundation year to make up for my lack of science A-levels. Most of the courses were the same as in a standard medicine degree, but there were witchier modules in materia medica and botany too.

  Over the next two years, I drew every bone, muscle and organ in the body, memorising their functions and their names, right down to the tiny bones of the hand: lunate and pisiform, named for their resemblance to moons and peas. On sheets of butcher’s paper, I mapped the metabolic transformations that went on inside the miniature factory of each cell. At the beginning I had only the crudest notion of how the body worked, but I struggled gamely on, fascinated and a little appalled by how much of my life happened beneath the Plimsoll line of conscious control. Gradually it all came into focus. The body was a device for processing the external world; a conversion machine, hoarding, transforming, discarding, stripping for parts.

  We studied the ideal body, the theoretical version, and then what could go wrong, working our way through hundreds of disorders, each with its own idiosyncratic pathology. The process of distinguishing between them was called differential diagnosis. We learned how to recognise the finger clubbing that foretells congestive heart failure, to differentiate the rash of eczema from that of psoriasis, to spot the bulging eyes and racing pulse of hyperthyroidism or the classic ‘lemon on sticks’ presentation of Cushing’s syndrome.

  We were initiated into the art of physical examination in a training clinic in pre-gentrification Bermondsey, spending giggly, embarrassed afternoons taking each other’s blood pressure and palpating livers and kidneys, which had to be caught between two jabbing hands like a bar of soap. Everything was meaningful. A wince as you poked at the base of a patient’s rib might indicate gallbladder disease. Fingernails that curved inward like spoons could mean iron-deficiency anaemia or haemochromatosis. The sheer amount of information was overwhelming but also wonderfully orderly, at least on paper.

  I began to see patients in my second year. Because the clinic was in central London and offered subsidised appointments, the diversity of patients was greater than tends to occur in private practice. I soon found that diagnosis was far more tangled and confusing than Davidson’s Principles and Practices of Medicine had led me to expect. For a start, people rarely had one illness, but came with a concatenation of conditions. An elderly man might have diabetes and heart disease and swollen ankles; a teenage girl Raynaud’s syndrome and painful periods and depression. You had to painstakingly assess each symptom, to trace it back to the source, before even
beginning to consider a treatment plan.

  Herbal medicine is narrative medicine, a tutor once said, and that phrase stuck with me. Because the prescription was dispensed at the very end of the session, the bulk of the hour was spent listening to the patient, drawing out their whole life story by way of their body. It was as close to psychotherapy, the talking cure, as any form of physical treatment could be. From the beginning, I was fascinated by the sense patients made of their own bodies, the way they experienced their physical and emotional lives as interwoven. In their telling, a divorce prompted cystitis, old griefs attached to tumours, the bereaved developed ulcers or lost their voices, like Freud’s famous patient Dora.

  After qualifying, I set up practice in a large white room in Hove, overlooking a long garden I wasn’t allowed to enter. There was a tiny dispensary off the hall, where I’d weigh out tisanes of meadowsweet and lavender on an old brass scale, digging out the five and ten gram counterweights and sneezing at the aromatic clouds of dust, an activity I still find myself carrying out sometimes in dreams. My patients were of all ages, from infants to the very old. I saw anorexic girls and whole families beset by anxiety. I saw people desperate to conceive, women who were so lonely it was a sickness in itself and men with weeks to live. I listened to their stories, and though I knew why buchu and horsetail would help one patient, and sweet violet and yarrow another, it still seemed to me that the abiding assistance I was providing was as a facilitator of narrative, a witness before whom the whole tangled yarn of the body’s difficulties could be unfolded and considered. It felt as if this process was in itself a source of healing, and it left me more fascinated than ever by the mysterious nature of illness, which arises and departs on tracks that are not always visible.

  There was a pernicious mode of thinking at the time, popular in New Age and alternative circles, which argued that all physical illness is caused by negative psychological states, the body a theatre in which suppressed or unacknowledged emotions wreak total havoc. One of the main sources was an elderly American woman called Louise Hay, a former model with white-blonde hair and a tight, uplifted face, who became a millionaire on the back of her 1984 self-help manual You Can Heal Your Life. It sold fifty million copies, making it one of the most read non-fiction books of all time. When her marriage broke up at the end of the 1960s, Hay started attending a spiritualist church, which introduced her to the concept of positive thinking. She claimed to have used it to cure herself of cervical cancer (when an interviewer at the New York Times asked her to prove this in 2008, she said she’d long since outlived any doctor who could confirm the diagnosis).

  In the Hay universe, the mind was far more powerful than the body. She taught that illnesses as serious as cancer would spontaneously resolve if the underlying psychological woe was addressed, not by medication or therapy but by positive affirmations, the practice of repeating slogans like ‘I am a beautiful person’ or ‘I am radiant with health’. It was as simple as a, b, c, and indeed in 2004 she published an alphabet of physical illnesses and their mental causes: acne caused by dislike of the self, arthritic fingers by a desire to punish, asthma by suppressed crying. Cancer was resentment and hatred, while polio was paralysing jealousy (a condition that apparently became vanishingly rare in England after the 1950s, when the polio vaccination was introduced).

  It didn’t surprise me that she’d become one of the best-selling authors of all time, a mere rung beneath the titans, Danielle Steele and Agatha Christie. Somehow it is more comforting to believe that sickness is consequential, a response to suppressed emotions or undigested traumas, than to confront the existential horror of randomness, the knowledge that anyone, no matter how good or innocent or emotionally healthy, might be afflicted at any time. To believe that illness is caused by their own mind gives the patient a kind of power over it, though also a terrible culpability. What I most hated about Hay’s theory was that it manoeuvred the blame for illness onto the person who was experiencing it. It was anti-science, and it housed a more insidious notion, too: that there is a right way for the body to be, and that illness or disability is the consequence of failure, while physical health is a reward for psychological balance.

  My own experience with patients made me certain that the relationship between soma and psyche was far more complicated than either Hay’s model or mainstream medicine allowed. Sometimes it was plain that emotional distress was at the root of physical symptoms (there’s evidence, for example, that past trauma has a substantial impact on the functioning of the immune system, as the psychiatrist Bessel van der Kolk discusses in his fascinating book The Body Keeps the Score). But the relationship wasn’t always that simple, or that unidirectional. The patients I saw were ill, and at the same time their illness was grounds for thinking about other arenas of their lives. Illness functioned as a way for them to acknowledge or express otherwise inadmissible pain, the afflictions of the body providing a ready language by which other things could be conveyed.

  At the very end of the Patrick Melrose quintet, the novelist Edward St Aubyn put this phenomenon into words so precise that I was jolted when I read it.

  His body was a graveyard of buried emotions; its symptoms clustered around the same fundamental terror . . . The nervous bladder, the spastic colon, the lower back pain, the labile blood pressure that leapt from normal to dangerously high in a few seconds, at the creak of a floorboard or the thought of a thought, and the imperious insomnia that ruled over them, all pointed to an anxiety deep enough to disrupt his instincts and take control of the automatic processes of his body. Behaviour could be changed, attitudes modified, mentalities transformed, but it was hard to have a dialogue with the somatic habits of infancy. How could an infant express himself, before he had a self to express, or the words to express what he didn’t yet have? Only the dumb language of injury and illness was abundantly available.

  It was this dumb language I longed to understand, the body speaking its own stubborn, elusive tongue.

  *

  Whether they knew it or not, both St Aubyn and Hay were drawing on the work of Wilhelm Reich. The foundation of all Reich’s thinking, good and bad, lies in a single idea he developed in Vienna between the wars: that our bodies carry our unacknowledged history, all the things we try to ignore or disavow. This is the seed that gave rise to his subsequent ideas about freedom, but it’s also the origin of the troubling, even dangerous theories about health he expounded in America.

  When Reich arrived in Vienna in the summer of 1918, he was twenty-one, a penniless Jewish soldier who’d spent the past three years as an infantry officer in the Austro-Hungarian army, trapped in the squalid trenches of the Italian front. The vast empire in which he’d grown up had suffered an overwhelming defeat and there was no home to which he could return. His parents had died when he was still a teenager, and the prosperous family estate in Bukovina had been abandoned during the Russian invasion. When the Austro-Hungarian Empire finally collapsed that November, it became part of Rumania (it’s now in Ukraine). Reich couldn’t afford the legal case to win it back.

  The city he washed up in was also in trouble. Vienna was no longer the capital of a wealthy and cosmopolitan empire, a place so opulent and luxurious it had been nicknamed the City of Dreams. The newly created Republic of German-Austria had lost two-thirds of its pre-war territory, cutting it off from most of its former sources of fuel and food. By the time Reich arrived, part of a mass migration of thousands of homeless and desperate fellow soldiers, hyperinflation had made the krone almost worthless. Wood was in such short supply that there were only paper coffins in which to bury the dead. Many of the corpses were victims of the global Spanish flu epidemic, now raging through the ruined city.

  That year, Reich lived off a subsistence diet of oatmeal and dried fruit, along with a slice of jam cake on Sundays and an eighth of a loaf of bread a week. But it wasn’t just meat and butter he craved. He was desperate for intellectual stimulation, an outlet for his considerable energy and intelligence, and
he also longed for love, companionship and sex. His future sister-in-law, who met him around this time, never forgot how this orphaned boy responded to the warmth of her family. She described him in terms you might use for a stray dog: ‘open, lost, hungry for affection as well as food.’ Other friends described Willie, as he was invariably known, as brilliant, energetic, far more vital than other people, but also gauche, insecure and arrogant, prone to fits of jealousy and depression. He was so handsome and dashing that you didn’t necessarily notice his skin was covered with the itchy red plaques of psoriasis, a condition that had tormented him since childhood.

  In October, Reich enrolled at the University of Vienna to study law, and after a dull term switched to medicine, a far more congenial subject, though his living conditions remained gruelling. The single room he shared with his younger brother Robert and another student was so cold he got frostbite despite wearing gloves and a fur coat. Once he collapsed from hunger in a class. Robert, who was working, helped him financially, but even so he was penniless until he started to tutor younger students in his second year, exhausting work that ate up precious hours of the day.

  Despite his interest in his classes, the dominant mechanistic model of medicine troubled Reich. He felt instinctively that something was missing: some kind of life essence or vital force that hadn’t yet been isolated or pinned down. It was all very well learning anatomy, but what was the thing that made him him, the appetite that propelled people through life? Sexual topics weren’t covered on the course, and he wasn’t the only student to feel it a serious omission. In January, a slip of paper passed from desk to desk during an anatomy lecture, inviting students to join an informal seminar on the secretive, shameful subject of sex. It was in this seminar that Reich first encountered the stunning ideas of Sigmund Freud.